13-100300 • •uilding - Single family
City F4,•daral
Community&Econ.Dev.Services
v. Permit #: 13-100300-00-SF
Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: PEDERSON
Project Address: 28124 23RD AVE S Parcel Number: 326081 0330
Project Description: REM-Previously constructed remodel to reconfigure living room and den and add
bathroom. Includes plumbing& mechanical.
Owner Applicant Contractor Lender
JAMES PEDERSON JAMES PEDERSON OWNER IS CONTRACTOR
28124 23RD AVE S 28124 23RD AVE S
FEDERAL WAY WA 98003-2962 FEDERAL WAY WA 98003-2962
Census Category: 434 - Residential alt/add- no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0 0 0 0
Additional Permit Information
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0
Mechanical to be Included? Yes Plumbing to be Included? Yes
Mechanical Fixtures
Fans 1
Plumbing Fixtures
Lavatories 1 Showers 1 Sinks 1
Water Closets 1
CONDITIONS:
Subject to field inspection with plans. e/e(ta
PERMIT EXPIRES Sunday, July 28, 2013
Permit Issued on Tuesday, January 29, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
a t Ci of Federal Way.
Owner or agent: - Date: l Z1
f
• THIS CARD IS TO MAIN ON-SITE
c,rroF °' Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 13-100300-00-SF Address: 28124 23RD AVE S
Project: JAMES PEDERSON FEDERAL WAY, WA 98003-2962
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
o SWM Precon Site Mfg(4400) 0 Initial Erosion Control(4365) 0 Plumbing Groundwork(4190)
Approved To be done prior to breaking ground Approved to cover
By Date By Date By Date
. . . .
El Underfloor Framing(4285) 0 Floor Sheathing(4105) Shear Walls(4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date By Date By Date
El Roof Sheathing(4220) El Rough Plumbing(4230) ® Mechanical Rough-in(4165)
Approved to install roofing Approved Approved
By Date By `..� i� Date l_I�, Byv.._ Li.- Date `-A-1 V 1
El Gas Piping(4125) ❑ Fire/Draft Stops(4095) ❑ Interim Erosion Control(4370)
Approved to release test Approved Approved
By Date By ,—.
Date _S_ By Date
,
�, Framing(4120)
El Insulation (4150)
Prior to scheduling a Framing inspection; /�
Electrical,Plumbing&Mechanical Rough-in and Approved to insulate Approved to install wallboard
Fire/Draft Stop inspections must be signed-off and /�
approved. IBC 109.3.4 By l�' tQ.w Date _S_` By Date
❑Gypsum Wallboard Nailing(4130) EI Final Erosion Control(4375) El
Final-Mechanical(4065)
Approved to install mud&tape Approved Approved
By Date r� c.
-- 'L By Date By ADate ,a --- -1
❑ Final-Plumbing(4075) E3 Final-Building(4050)
Approved Approved
By Date .w--�-v By ,- Date "1-1.- 12)
Rough Electrical
Final Electrical
Right of Way
ElApproved ElRough
r] Approved
By Date By Date By Date
RECEIVED
m20�3 PERMI'�APPLICATION
Federal Way JAN _ Z9.. 13
CITY OF FEDERAL WAY 0°
CDS
PERMIT NUMBER f _ / 00
0Q U _ TARGET DATE
`��
SITE ADDRESS } I VA �� , F ' SUITE/UNIT#
PROJECT VALUATION ZONING V ASSESSOR'S TAX/PARCEL# �J`
x5000 g2_ 10s I - 0330
TYPE OF PERMIT �J BUILDING PLUMBINGECHANICAL ❑ DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
)11.
NAME OF PROJECTp,�s�
PROJECT DESCRIPTION Ju Z fle n o� / E( v/ _4 —
Detailed description of work to ' Dei-‘)/ Ree : 0$,-) )4:444-1 O --'
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER e•-•€_5 JL 5 '2-067 9-00f
MAILING ADDRESS E-MAIL
3 .
CITY,. STATE ZIP
1-6Oti 14 I IA.Jka-C.( , / i�c7� AS,Soc it c Pe 1,1z) (1C
NAME ADcu1/4CJ�-\., PHONE
MAILIN DRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAMEPRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY / STATE ZIP� FAX
Fever-#1 WA I Wit ��073
NAME PRIMARY PHONE
PROJECT CONTACT ►`fib:. A ! � Ul I- _
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME "" OWNER-FINANCED
PROJECT FINANCING /1,LI/V ❑
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to thl city as a part of this a 'cation.
SIGNATURE: C. � �/ V DATE I
in//3
PRINT NAME: I 3/9 tvi G ' Pe-De-7z 6 p----
Bulletin#100 January 1,2013 Page 1 of 3 k:AHandouts\Permit Application
. VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
$ /'lib
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS / FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercia)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $ ei,670
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
in
BATHTUBS(or Tub/Shower combo) LAVS(Hand Sks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS I SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electrie)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTINGpIMPROVEMENTS
$ o coo
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes It No ❑Yes EyNo
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home) /35 C) / -r✓E
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
EDT AREA ONLY
Bulletin#100-January 1,2013 Page 2 of 3 k:\Handouts\Permit Application